HIV influences both the epidemiology and the clinical features of many other infectious diseases, malignancies and other illnesses (e.g. renal disease) (see Chapter 10).47 In HIV-infected patients, immunodeficiency increases the risk that atypical (opportunistic) pathogens will result in clinical illness, and is associated with atypical presentations of some diseases. In addition, HIV-infected patients frequently present with multiple pathologic processes simultaneously, making decisions regarding empiric treatment very challenging. We describe the relationship between HIV and three common infectious diseases that have complex and important interactions.
Supporters of a comprehensive approach say AIDS demands frankness. Originating in comprehensive sex ed. theory, their ideas also came from pacesetting health authorities such as former surgeon general c. everett koop. Arguing in the mid-1980s that AIDS classes should be specific and detailed and taught as early as kindergarten, Koop countered conservative arguments by saying, “Those who say ‘I don’t want my child sexually educated’ are hiding their heads in the sand.” This position holds that educators are obligated to teach kids everything that can stop the spread of the disease. “What is the moral responsibility?” Jerald Newberry, a health coordinator of Virginia schools, asked the Washington Times in 1992. “I think it’s gigantic.” Abstinence is a part of this approach, but expecting teens to refrain from having sex was considered by many to be unrealistic given some studies that show that nearly three out of four high school students have had sex before graduation. Thus, the comprehensive curriculum might well include explaining the proper use of condoms, discussing homosexual practices, describing the sterilization of drug needles, and so on.
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Palella FJ Jr, Deloria-Knoll M, Chmiel JS, Moorman AC, Wood KC, Greenberg AE, et al. Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell strata. HIV Outpatient Study Investigators. Ann Intern Med 2003;138:620–6. [PubMed] [Full Text] ⇦
Stanley TL, Falutz J, Marsolais C, et al. Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clin Infect Dis. 2012 Jun. 54(11):1642-51. [Medline]. [Full Text].
Sturdevant moved his seat back, preparing for a long drive, and adjusted the radio to 107.5, the local R.&B. oldies station. Toni Braxton’s wail — “I wish you’d hold me in your arms like that Spanish guitar” — filled the car. He was headed to a small town 90 miles east of the city to visit Jordon, an H.I.V.-positive 24-year-old. When Sturdevant himself was at his lowest point, he said, “I looked something like this boy we’re going to see.”
The size of the proviral reservoir correlates to the steady-state viral load and is inversely correlated to the anti-HIV CD8+ T-cell responses. Aggressive early treatment of acute infection may lower the proviral load, but generally, treatment in newly infected (but postseroconversion) patients yields no long-term benefit.
Riley-Day syndrome; familial dysautonomia autosomal-dominant complete indifference to pain; also characterized by orthostatic hypotension, hyperhidrosis and hyporeflexic/absent deep tendon reflexes, pes cavus and trophic plantar ulceration
Jump up ^ Forrester, JE; Sztam, KA (December 2011). “Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?”. The American Journal of Clinical Nutrition. 94 (6): 1683S–1689S. doi:10.3945/ajcn.111.011999. PMC 3226021 . PMID 22089440.
n a type of retrovirus that causes AIDS. Retroviruses produce the enzyme reverse transcriptase, which allows transcription of the viral genome onto the DNA of the host cell. It is transmitted through contact with an infected individual’s blood, semen, cervical secretions, cerebrospinal fluid, or synovial fluid. It infects T-helper cells of the immune system and results in infection with a long incubation period, averaging 10 years.
Jump up ^ Keele BF, Van Heuverswyn F, Li Y, Bailes E, Takehisa J, Santiago ML, Bibollet-Ruche F, Chen Y, Wain LV, Liegeois F, Loul S, Ngole EM, Bienvenue Y, Delaporte E, Brookfield JF, Sharp PM, Shaw GM, Peeters M, Hahn BH (2006). “Chimpanzee reservoirs of pandemic and nonpandemic HIV-1”. Science. 313 (5786): 523–6. Bibcode:2006Sci…313..523K. doi:10.1126/science.1126531. PMC 2442710 . PMID 16728595.
Longo DL, et al., eds. Human immunodeficiency virus disease: AIDS and related disorders. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed Dec. 15, 2017.
The vast majority of infections remain in sub-Saharan Africa, where 5.2% of the population is thought to be infected. Between 2004 and 2006, the prevalence of HIV infection in central and eastern Asia and Eastern Europe increased by 21%. During this period, the number of new HIV infections in persons aged 15 to 64 years rose by 70% in Eastern Europe and central Asia.
^ Jump up to: a b Baggaley, RF; Boily, MC; White, RG; Alary, M (April 4, 2006). “Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis”. AIDS (London, England). 20 (6): 805–12. doi:10.1097/01.aids.0000218543.46963.6d. PMID 16549963.
Jump up ^ Ricci, E. P.; Herbreteau, C. H.; Decimo, D.; Schaupp, A.; Datta, S. A. K.; Rein, A.; Darlix, J. -L.; Ohlmann, T. (2008). “In vitro expression of the HIV-2 genomic RNA is controlled by three distinct internal ribosome entry segments that are regulated by the HIV protease and the Gag polyprotein”. RNA. 14 (7): 1443–55. doi:10.1261/rna.813608. PMC 2441975 . PMID 18495939.
The success of ART is assessed by measuring plasma HIV RNA levels every 8 to 12 wk for the first 4 to 6 mo or until HIV levels are undetectable and every 3 to 6 mo thereafter. Increasing HIV levels are the earliest evidence of treatment failure and may precede a decreasing CD4 count by months. Maintaining patients on failing drug regimens selects for HIV mutants that are more drug-resistant. However, compared with HIV, these mutants appear less able to reduce the CD4 count, and failing drug regimens are often continued when no fully suppressive regimen can be found.
HIV is the causative agent of Acquired Immunodeficiency Syndrome (AIDS). AIDS is a severe, life-threatening disease that represents the late clinical stage of infection with the HIV. 2.5 million people died of AIDS in 2005 alone, and estimates place the number of people living with HIV/AIDS at 38.6 million. HIV/AIDS has claimed more than 25 million lives since 1981.
…highest rate of HIV and AIDS infection of any country in Asia. Aggressive programs launched by the government to promote safe sex practices, however, have reduced the rate of increase in new HIV infections significantly. Nonetheless, AIDS has continued to claim the lives of several tens of thousands of people…
A fusion inhibitor blocks an early step in the viral life cycle. Enfuvirtide (Fuzeon, T-20) attaches to the envelope surrounding the virus and prevents it from entering the CD4 cells. This prevents the infection of CD4 cells by HIV. T-20 is the first approved drug in this class. It is given as a twice-daily subcutaneous injection (90 mg). It is used primarily in individuals who have developed resistance to other classes of drugs in order to create a new potent combination. Like all other antivirals, it is most useful in those taking other active drugs at the same time in order to optimize the chance of getting viral loads to undetectable levels and to prevent the development of drug resistance.
Jump up ^ Young, TN; Arens, FJ; Kennedy, GE; Laurie, JW; Rutherford, G (January 24, 2007). Young, Taryn, ed. “Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure”. Cochrane Database of Systematic Reviews (1): CD002835. doi:10.1002/14651858.CD002835.pub3. PMID 17253483.
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During the latent period, the virus continues to multiply actively. It infects and kills critical infection fighting cells, a type of white blood cell called CD4 cells or T helper cells (T cells). Even though the person has no symptoms, he or she is contagious and can pass HIV to others through the routes described above. At the end of this phase, as the virus overwhelms the CD4 cells, the HIV viral load starts to rise, and the CD4 cell count begins to drop. As this happens, the person may begin to have symptoms as the virus levels increase in the body. This is stage 3.
Post-exposure prophylaxis (PEP) is the use of ARV drugs within 72 hours of exposure to HIV in order to prevent infection. PEP includes counselling, first aid care, HIV testing, and administration of a 28-day course of ARV drugs with follow-up care. WHO recommends PEP use for both occupational and non-occupational exposures and for adults and children. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]